Dietary intake of n–3 long-chain polyunsaturated fatty acids and coronary events in Norwegian patients with coronary artery disease

Manger, Mari S; Strand, Elin; Ebbing, Marta; Seifert, Reinhard; Refsum, Helga; Nordrehaug, Jan Erik; Nilsen, Dennis W.T.; Drevon, Christian A.; Tell, Grethe S.; Bleie, Øyvind; Vollset, Stein Emil; Pedersen, Eva Kristine Ringdal; Nygård, Ottar

doi:10.3945/ajcn.2010.29175

Cited by 31 publications

(35 citation statements)

References 28 publications

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“…[1][2][3][4][5] In some studies no such association has been observed, [33][34][35] or an association has been seen for some but not for other cardiovascular outcomes. 36 Based on our English-language Medline search through October 2010, it is apparent that only a few studies have been Figure.…”

Section: Discussionmentioning

confidence: 99%

Fish, n-3 Fatty Acids, and Cardiovascular Diseases in Women of Reproductive Age

Strøm

Halldórsson²,

Mortensen³

et al. 2012

Hypertension

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Abstract-Previous studies have indicated a protective effect of long-chain n-3 polyunsaturated fatty acids (LCn3FAs) against cardiovascular disease; however, women are underrepresented in cardiovascular research. The aim of this study was to explore the association between intake of LCn3FAs and the risk of cardiovascular disease in a large prospective cohort of young women (mean age at baseline: 29.9 years [range: 15.7-46.9] Key Words: cardiovascular diseases Ⅲ fatty acids Ⅲ epidemiology Ⅲ follow-up study Ⅲ women E vidence from observational prospective studies, 1-5 as well as randomized, controlled trials, 6 -8 suggests a protective effect of fish consumption and intake of the essential long-chain n-3 polyunsaturated fatty acids (LCn3FAs) against cardiovascular disease. The hypothesis of a beneficial cardiovascular effect of LCn3FAs originally stems from studies in the Greenland Inuit, where the incidence of coronary heart disease, and, in particular, acute myocardial infarction, was very low. 9 Although findings have not been consistent, 10,11 both previous and recent reviews have concluded that there is solid evidence of a protective effect of LCn3FAs against cardiovascular diseases, 12-16 whereas, on the other hand, a much debated Cochrane review from 2004 concluded that it is unclear whether dietary or supplemental LCn3FAs alter the risk of cardiovascular events in high-risk groups or in the general population. 17 A recent review of the cardiovascular effects of LCn3FAs concluded that, whereas there is evidence of several beneficial cardiovascular effects of LCn3FAs, there are still many uncertainties in the field, for example, regarding arrhythmic events. 18 Recently it has been emphasized by experts that cardiovascular risk in women is underestimated, and women are underrepresented in cardiovascular research. 19,20 Even if most risk factors are shared by men and women, there might be sex differences with regard to their impact, 21 and inflammation, high-density lipoprotein, and triglyceride levels might have a more negative influence on cardiovascular risk in women than in men. 21 Because these risk factors are supposedly affected by LCn3FA intake, this underlines a need for studies on the importance of LCn3FAs in women.The large birth cohorts that have emerged in several countries in the last decade provide information collected on a wide range of exposures and characteristics, which can facilitate such observational studies on etiologic associations in female populations. The aim of this study was to examine

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Section: Discussionmentioning

confidence: 99%

Fish, n-3 Fatty Acids, and Cardiovascular Diseases in Women of Reproductive Age

Strøm

Halldórsson²,

Mortensen³

et al. 2012

Hypertension

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“…Two studies (18,42) were excluded because the reference group was not the lowest exposure group. Two studies (7,20) were excluded because their reference fish intake categories were extremely high compared with other studies. One study (34) possessing a greatly different CHD baseline risk compared with the risk for the general population was ruled out.…”

Section: Discussionmentioning

confidence: 99%

“…Figure 1 presents the detailed selection process. We identified twenty-nine potential studies (5)(6)(7)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) . Seven studies (29,(31)(32)(33)37,43,44) were excluded because of their incomplete information on RR estimation or fish intake.…”

Section: Discussionmentioning

confidence: 99%

“…However, stratified analyses in these meta-analyses were limited and could not help explain the heterogeneity. In addition, among several (7,(13)(14)(15)(16)(17)(18)(19)(20) recently published cohort studies, most (7,13,15,17,18,20) of them showed no statistically significant inverse association between fish intake and CHD mortality. Therefore, these results to date are still inconsistent and more detailed stratified analyses need to be done to find the potential heterogeneity.…”

mentioning

confidence: 99%

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Fish consumption and CHD mortality: an updated meta-analysis of seventeen cohort studies

Zheng

Huang

et al. 2011

Public Health Nutr.

278

185

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Objective: Results of studies on fish consumption and CHD mortality are inconsistent. The present updated meta-analysis was conducted to investigate the up-to-date pooling effects. Design: A random-effects model was used to pool the risk estimates. Generalized least-squares regression and restricted cubic splines were used to assess the possible dose-response relationship. Subgroup analyses were conducted to examine the sources of heterogeneity. Setting: PubMed and ISI Web of Science databases up to September 2010 were searched and secondary referencing qualified for inclusion in the study. Subjects: Seventeen cohorts with 315 812 participants and average follow-up period of 15?9 years were identified. Results: Compared with the lowest fish intake (,1 serving/month or 1-3 servings/ month), the pooled relative risk (RR) of fish intake on CHD mortality was 0?84 (95 % CI 0?75, 0?95) for low fish intake (1 serving/week), 0?79 (95 % CI 0?67, 0?92) for moderate fish intake (2-4 servings/week) and 0?83 (95 % CI 0?68, 1?01) for high fish intake (.5 servings/week). The dose-response analysis indicated that every 15 g/d increment of fish intake decreased the risk of CHD mortality by 6 % (RR 5 0?94; 95 % CI 0?90, 0?98). The method of dietary assessment, gender and energy adjustment affected the results remarkably. Conclusions: Our results indicate that either low (1 serving/week) or moderate fish consumption (2-4 servings/week) has a significantly beneficial effect on the prevention of CHD mortality. High fish consumption (.5 servings/week) possesses only a marginally protective effect on CHD mortality, possibly due to the limited studies included in this group.

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“…We estimated daily total intake of energy, as well as choline and betaine according to the USDA Database for the Choline Content of Common Foods (17 ), among 1939 patients who provided information on average dietary habits during the last year from food frequency questionnaires, as described elsewhere (18 ). We also calculated ␤-cell function, insulin sensitivity, and IR among 877 fasting patients without established type 2 diabetes at baseline with the computer-based updated homeostatic model assessment (HOMA2), as previously reported (19 ).…”

Section: Clinical and Biochemical Datamentioning

confidence: 99%